Intravenous indomethacin for postoperative pain A double-blind study of ankle surgery

Intravenous indomethacin infusion (75 mg/10 h) for relief of pain after ankle surgery was compared with placebo in a double-blind study. Ninety-seven patients were operated on for a malleolar fracture or ruptured ligament of the ankle under single-dose spinal anesthesia. In the indomethacin group, 14 out of 49 patients were free from pain, 4/47 in the control group. Severe pain was experienced by 24/49 in the indomethacin group and by 41/47 in the control group. Supplementary intramuscular oxycodone was needed for 24 patients in the indomethacin group and for 41 control patients. In 1 patient, i.v. indomethacin administration caused serious arterial hypotension necessitating discontinuation of the medication. Intravenous indomethacin reduced the need of opiate for alleviation of postoperative pain, but the possibility of hypersensitivity reaction calls for particular attention.